Two days into the largest nursing strike New York City has seen in decades, Mount Sinai Hospital made a startling accusation. Three nurses had been fired, administrators said, after they were caught “deliberately sabotaging” the labor-and-delivery floor by hiding critical supplies for newborns so that replacement nurses would not find them.
“This is completely unacceptable behavior,” the hospital said in a statement on Tuesday, adding that the action last week risked “interfering with patient safety.”
Two of the nurses defended themselves at a news conference near the picket line outside the hospital. The allegation, they said in an interview, was false — they had simply been gathering supplies for an incoming patient so that they were ready for a delivery, a practice known as preparing a “bucket.” The third nurse said that she had nothing to do with it and had no idea why she had been accused.
The allegation illustrated the growing rancor between some of the leading hospitals in the city and a key component of their work force, nurses. To the workers on the picket line, the public accusation of sabotage starkly illustrated how the ongoing strike diverged from a 2023 walkout.
“It’s completely different this time,” Margit Anderegg, a Mount Sinai nurse, said in an interview after spending the day on the picket line. She was thinking back to the strike three years ago, which involved 7,000 nurses at Mount Sinai in Manhattan and Montefiore Medical Center in the Bronx. That strike, the first by hospital nurses in New York City in a quarter century, was resolved in just three days, with nurses winning most of their demands.
Three years ago, the hospitals seemed taken by surprise that the nurses had actually gone on strike. Not this time.
Facing nearly 15,000 striking nurses, the hospitals — Montefiore, NewYork-Presbyterian/Columbia and three hospitals in the Mount Sinai system — have cumulatively spent more than $100 million to hire temporary nurses and rent hotel rooms for them and to keep things running smoothly, according to Kenneth E. Raske, the president of the Greater New York Hospital Association, a trade group that has assisted hospitals with planning for the strike.
“This is way more preparation than I saw three years ago, and I think the resolve of the hospitals is significant,” he said.
The hospitals have signaled a greater willingness to dig in and fend off the nurses’ demands, which they have characterized as out of touch. And they don’t seem worried about escalating a fight with the nurses, who are generally more trusted and held in higher regard than members of just about any other profession.
Nurses at Montefiore have told union representatives that since the strike began, they have been barred from using a hospital pharmacy, according to the union, which filed a complaint on Wednesday with the National Labor Relations Board.
In recent months, Mount Sinai has disciplined 14 nurses who are vocal union advocates, according to the New York State Nurses Association, which says much of the discipline was in retaliation for speaking to colleagues about union activities or speaking to the news media about safety concerns following a shooting.
“This discipline was a result of violating Mount Sinai policy that impacted patient safety and was unrelated to union activity,” a hospital spokeswoman said.
“We continue to be shocked by how aggressively they are coming after us nurses, particularly because we hope to go back to work again soon and continue looking after our patients,” said Matt Allen, a Mount Sinai labor-and-delivery nurse who is a union delegate.
The dynamics between nurses and hospitals have changed significantly in the past three years. “It really is a flip of circumstances,” Mr. Raske said.
In 2023, hospitals were buoyed by federal bailout money that subsidized them during the coronavirus pandemic. And New York City’s nurses were hailed as heroes who had held the line during the deadly first wave of Covid-19. But they were grappling with widespread burnout and deteriorating working conditions.
Chronic understaffing had left nurses in hospitals across the city with too many patients to properly care for at once. That longstanding problem worsened as the virus thinned out the nursing work force.
Some nurses had left the profession by 2021, either because of burnout or early retirement. Others left full-time hospital jobs for lucrative contracts as traveling nurses. By 2022, a survey found that more than half of nurses were considering leaving their positions primarily because of insufficient staffing.
By the time the nurses went on strike in 2023, they had already won agreements to significantly boost their pay — winning nearly 20 percent raises over the course of a three-year contract, which propelled starting salaries at major Manhattan hospitals to about $120,000.
But by going on strike, the nurses locked in an agreement on nurse-to-patient ratios with enforcement mechanisms. When hospitals left units chronically understaffed, nurses could force hospitals to pay them extra. Nurses in the Mount Sinai Health System were awarded $4.7 million from arbitrators in 2024 in nine understaffing cases.
Hospitals have chafed at these awards and sought to chip away at them. NewYork-Presbyterian has gone to federal court to appeal a similar arbitration ruling.
Today, the financial outlook for hospitals is quite different from several years ago. Hospitals anticipate lean years ahead as more than a million New Yorkers lose health insurance and federal health care subsidies to the state are cut by billions of dollars — a result of the domestic policy bill that President Trump signed in July.
At the same time, nurses’ financial position has improved, with many on strike making a base salary of more than $150,000 a year. Hospitals say their demands, which would push average salaries toward $200,000 a year, are more than the hospitals can afford.
Hospital executives appear to have decided, after the nurses’ 2023 win, to stand their ground this time. They are wary that if they fold too quickly, they will see a strike every three years, when contracts expire.
“It’s looking like the modus operandi of union leadership is that every few years they want to have a strike, which is incomprehensible, but that is what they’re up to,” Mr. Raske said.
The last strike lasted just three days. But three days into the current strike, both sides are digging in. Mr. Raske said that the affected hospitals could keep their medical centers up and running with contract nurses.
“By day three, we’ve gotten into more normalized operations, which we expect to continue for the foreseeable future,” he said. “In other words, things are not falling apart.”
Mount Sinai Hospital even claimed that more nurses were crossing the picket line by the day, with about 23 percent returning to work by Wednesday. Union officials have said an overwhelming majority of members are participating in the strike.
“We have now committed significant additional funds to maintain our qualified and specialized agency nurses so that we can continue to be prepared to provide safe patient care at least through next week as the strike continues,” Mount Sinai said in a statement.
But several nurses said in interviews that their resolve would hold.
“We’re expecting this to be at least several weeks, but we’re prepared to be out as long as we need to be out,” Mr. Allen, the Mount Sinai nurse, said.
Samantha Latson contributed reporting.
Joseph Goldstein covers health care in New York for The Times, following years of criminal justice and police reporting.
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